Objective:To observe the effects of Qizhi Tongluo Prescription on renal interstitial fibrosis in rats with membranous nephropathy based on the Shh/Gli1 signaling pathway; To explore its intervention mechanism.Methods:Totally 60 male SD rats were divided into blank group ( n=10) and model group ( n=50) using random number table method. The model of membranous nephropathy was established according to the modified Border method. The successfully modeling rats were divided into model group, benazepril group and Qizhi Tongluo Prescription low-, medium- and high-dosage groups using random number table method. Benazepril group was gavaged with benazepril hydrochloride 10 mg/kg, Qizhi Tongluo Prescription low-, medium- and high-dosage groups were gavaged with Qizhi Tongluo Prescription solution 1.22 g/kg, 2.43 g/kg and 4.86 g/kg, and blank group and model group were gavaged with equal volume of normal saline, once a day, for 4 weeks. The 24-hour urine was collected to detect the 24-hour urinary protein quantification, and the blood was taken from the abdominal aorta to detect the levels of total cholesterol (TC), triglyceride(TG), and serum albumin(ALB); the pathological changes of rat kidney were observed by light microscope and transmission electron microscope; the protein expressions of sonic hedgehog factor (Shh), zinc finger protein 1 (Gli1) and α-smooth muscle actin (SMA) in renal tissues were detected by immunohistochemistry; the protein expressions of Shh, Gli1, α-SMA, TGF-β1, Collagen Ⅳ and plasminogen activator inhibitor-1 (PAl-1) in renal tissues were detected by Western blot. Results:Compared with the model group, the quantitative level of 24-hour urinary protein of rats in each administration group decreased ( P<0.05), serum TC and TG levels increased ( P<0.05), ALB level decreased ( P<0.05), the positive expressions of Shh, Gli1, α-SMA protein in renal tissue decreased ( P<0.05), and the protein expressions of Shh, Gli1, α-SMA, Collagen Ⅳ, TGF-β1, PAI-1 in renal tissue decreased ( P<0.05). Conclusion:Qizhi Tongluo Prescription can improve renal interstitial fibrosis in membranous nephropathy rats, possibly by inhibiting the Shh/Gli1 signaling pathway to delay renal interstitial fibrosis.

ObjectiveTo observe the intervention effect of Dahuang Xiezhuo prescription （DHXZ） on inflammation and suppressor of cytokine signaling 3 （SOCS3）/Toll-like receptor 4 （TLR4） pathway in rats with chronic renal failure （CRF）， and to explore its molecular mechanism in alleviating renal inflammatory response. MethodThe 90 male SD rats， 15 were randomly selected as sham group， and the remaining 75 were used as modeling group to replicate CRF rat model by 5/6 nephrectomy. After successful modeling， the rats were randomly divided into model group， DHXZ low-， medium-， high-dose groups （6.825， 13.65， 27.3 g·kg^-1） and Niaoduqing Granules group （2.6 g·kg^-1）. The drug intervention groups received corresponding drugs by gavage for 8 consecutive weeks. After administration， hematoxylin-eosin （HE） staining and Masson staining were used to observe the morphological changes of rat renal tissue， and blood creatinine （SCr）， blood urea nitrogen （BUN） and blood uric acid （UA） were tested. Enzyme-linked immunosorbent assay （ELISA） was performed to detect the serum contents of interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α） and C-reactive protein （CRP）. The mRNA expressions of SOCS3 and TLR4 in renal tissue were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， and the protein expressions of SOCS3， TLR4， nuclear transcription factor （NF-κB） and myeloid differentiation factor （MyD88） were detected by Western blot. Immunohistochemistry was used to determine the protein expressions of NF-κB， MyD88， NOD-like receptor protein 3 （NLRP3） and melanoma deficiency factor 2 （AIM2）. ResultCompared with the sham group， the model group had a significant inflammatory response in renal tissue， and an increase in blood SCr， BUN， UTP， IL-6， TNF-α and CRP （P<0.05）. The protein and mRNA expressions of SOCS3 in renal tissue of rats in the model group were lower while the protein expressions of TLR4， NF-κB， MyD88， NLRP3 and AIM2 and the mRNA expression of TLR4 were higher than those in the sham group （P<0.05）. Compared with the model group， DHXZ and Niaoduqing granules groups presented markedly reduced inflammatory response in renal tissue and decreased blood SCr， BUN， UTP， IL-6， TNF-α and CRP （P<0.05）. Additionally， DHXZ and Niaoduqing granules up-regulated the protein and mRNA expressions of SOCS3 in renal tissue while down-regulated the protein expressions of TLR4， NF-κB， MyD88， NLRP3 and AIM2 and the mRNA expression of TLR4 （P<0.05）. ConclusionDHXZ can reduce the release and expression of inflammatory factors， inhibit the inflammatory response and improve renal function， and the mechanism may be related to the regulation of SOCS3/TLR4 signaling pathway.

ObjectiveTo observe the effect of salvianolate on the protein expressions of adenosine monophosphate （AMP）-activated protein kinase （AMPK）， silent information regulator 1 （SIRT1） and peroxisome proliferator-activated receptor-γ coactivator-1α （PGC-1α）， autophagy and apoptosis in kidney tissue of rats with membranous nephropathy （MN）， and to explore its possible molecular mechanism against MN. MethodEighty male SD rats were randomly divided into normal group， model group， benazepril hydrochloride group （10 mg·kg^-1）， and salvianolate low-， medium-， and high-dose groups （16.7， 33.3 and 66.7 mg·kg^-1）. The rats were modeled by injection of cationized bovine serum albumin （C-BSA） into the tail vein. After successful modeling， rats in the administration groups were given corresponding doses of drugs for 4 consecutive weeks， and then 24-hour urine， serum and kidney tissue were collected for the detection of 24-hour urinary protein （UTP）， blood urea nitrogen （BUN）， serum creatinine （SCr）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， C reactive protein （CRP）， glutathione peroxidase （GSH-Px）， superoxide dismutase （SOD）， and malondialdehyde （MDA）. The pathological changes of kidneys were observed by light microscope， electron microscope and immunofluorescence. Western blot was used to detect the protein expressions of phospho-AMPK （p-AMPK）， AMPK， phospho-SIRT1 （p-SIRT1）， SIRT1 and PGC-1α in rat kidney tissue. The protein expressions of autophagy-specific gene （Beclin-1）， microtubule-associated protein 1 light chain 3 （LC3） Ⅱ， ubiquitin-binding protein （p62）， B cell lymphoma （Bcl-2）， Bcl-2-associated X （Bax）， and cysteine aspartic protease-7 （Caspase-7） in rat kidney tissue were determined by immunohistochemistry （IHC）. ResultCompared with the conditions in the normal group， the levels of UTP， IL-6， TNF-α， CRP and MDA in the model group were increased （P<0.05） while the levels of SOD and GSH-Px were decreased （P<0.05）， and there was no difference in BUN and SCr. Compared with the model group， the administration groups had lowered UTP， IL-6， TNF-α， CRP and MDA （P<0.05） while elevated SOD and GSH-Px （P<0.05）. It could be seen from hematoxylin and eosin （HE） staining， Masson staining， immunofluorescence and electron microscopy that the pathological damage of rat kidney tissue in the model group was significant， but after treatment with benazepril hydrochloride and salvianolate， the pathological damage of kidney cells was gradually improved. The expressions of p-AMPK/AMPK， p-SIRT1/SIRT1， PGC-1α， Bcl-2， Beclin-1 and LC3Ⅱ in rat kidney in the model group were lower than those in the normal group （P<0.05） while the expressions of Bax， Caspase-7 and p62 were higher （P<0.05）. Compared with the model group， benazepril hydrochloride group and salvianolate groups had an up-regulation in the expressions of p-AMPK/AMPK， p-SIRT1/SIRT1， PGC-1α， Bcl-2， Beclin-1 and LC3Ⅱ in the kidney （P<0.05） while a down-regulation in the expressions of Bax， Caspase-7 and p62 （P<0.05）. ConclusionThe protective effect of salvianolate on the kidneys of MN rats may be related to the activation of AMPK/SIRT1/PGC-1α signaling pathway， the up-regulation of autophagy and the reduction of apoptosis.

Objective:To investigate the correlation between hyponatremia and the severity of coronavirus disease 2019 (COVID-19).Methods:Clinical data of 12 patients with COVID-19 admitted to Shantou Central Hospital from January 23 to February 5 in 2020 were retrospectively analyzed, including gender, age, symptoms, lab test and clinical outcomes, to analyze the change trend of blood Na + level in the patients with COVID-19. Results:Among the 12 patients with COVID-19, there were 8 males and 4 females with the mean age of (38.0±16.3) years old, most of them were admitted to the hospital with cough and/or fever. All patients had a positive nucleic acid test for 2019 novel coronavirus (2019-nCoV), and were discharged after clinical treatment with oxygen therapy, antiviral, antibacterial, anti-inflammatory, and nutritional support. All patients were of ordinary type when they were admitted to the hospital. Among them, 1 patient turned into a severe case during the course of the disease, and 1 patient showed a tendency to become severe case. It was found that 10 patients without severe conversion had an average blood Na + of (138.3±1.3) mmol/L at admission, and the lowest blood Na + during the course of disease was (135.9±3.1) mmol/L. However, 2 patients who became severe and had a tendency to become severe disease (Na + levels at admission were 140.0 mmol/L and 138.0 mmol/L, respectively) experienced hyponatremia during the course of the disease (the lowest blood Na + levels were 129.0 mmol/L and 122.0 mmol/L). Further analysis showed that the lower serum Na + level, the higher level of white blood cell count (WBC) and C-reactive protein (CRP), but serum Na + level was consistent with the change trend of lymphocytes, suggesting that hyponatremia was closely correlated with severe inflammation reaction. Conclusions:Serum Na + showed decreasing tendency during the development of COVID-19, and hyponatremia was closely related to the severity of COVID-19. It was necessary to pay great attention to the change trend of blood Na + level. However, further research was needed to obtain more reliable conclusions and explorer the pathophysiological mechanisms.

Objective To study the analysis of folic acid combined with vitamin for level two ischemic stroke prevention effect. Methods From April 2013 to January 2014 in our hospital , selected the patients with stroke in 100 cases as the research object. In digital method were randomly divided into observation group (50 cases) and control group (50 cases). The patients in the observation group was taken folic acid combined with vitamin , the control group only was given vitamins, in all patients on admission and at discharge on the plasma levels of Hcy, D-two dimer, fibrinogen, three glycerol, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol level, the effect of folic acid combined with the vitamin was observed. Results No significant differences between the two groups before treatment, plasma Hcy levels (P>0.05) in different ways, the observation group after treatment, the plasma Hcy levels were significantly lower than the control group , with significant difference ( P<0 . 05 ) . Two groups by different ways of treatment, the observation group was best accounted for 70% (35/50), the excellent and good rate was as high as 98% (49/50), significantly higher than the control group 44% (22/50) and 74% (37/50), with significant difference (P<0.05). On two groups of different ways of treatment of cerebral was stroke recurrence and score in patients with SIAS were compared, the recurrence rate of the observation group was lower than the control group, with significant difference (P<0.05), the SIAS score was significantly higher than that of the control group, with significant difference (P<0.05). Conclusion For the patients with stroke, should the use of folic acid combine with vitamin two level of prevention. The combine uses of folic acid and vitamin , can effectively reduce the incidence of stroke and recurrence rate.

Ischemic stroke is an important cause of death and disability.Hemorrhagic transformation (HT) is a serious complication of acute ischemic stroke,especially in patients receiving intravenous thrombolytic therapy.Identifying patients at high risk of HT is very important for improving stroke outcomes.Some studied have shown that several serum biomarkers can be used to predict HT risk in patients with acute ischemic stroke.This article reviews the serum biomarkers of HT after acute ischemic stroke.

Objective To compare the effect of high volume continuous blood purification (CBP) with routine CBP on multiple organ dysfunction syndrome(MODS).Methods 38 patients with MODS were randomly divided into high volume CBP group( treatment group,18 cases) and routine CBP group (control group,20 cases).And they were respectively detected on mean arterial pressure(MAP),dosage of Dopamine,PaO2/FiO2,APACHE [ score,lactic acid,length of stay and mortality in ICU post-treatment 24h and 48h.Results Compared with control group,MAP and PaO2/FiO2 on treatment group were more higher( P ＜ 0.05 ),while dosage of Dopamine,APACHE Ⅱ score,lactic acid were significantly shorter than these of treatment group( P ＜ 0.05 ),and length of stay and mortality in ICU were significantly lower than those of treatmen group [ ( 8.54 ± 4.15 ) d vs ( 11.82 ± 5.76) d,P ＜ 0.05:22.2％ vs 35.0％,P ＜0.05 ].Conclusion High volume CBP could reduce the mortality in ICU compared with control group routine CBP.

Objective To study the effects of duration of migration from sea-level to high-altitude on cerebral hemodynamic parameters and their ethnic differences.Methods This randomized comparative study recruited 5 groups of healthy male subjects which were native Hans at sea-level (NHS),Han migrants from sea-level to high-altitude (HMSH,where HMSH-a for residence duration of 4 days,HMSH-b for 1 year,and HMSH-c for 5 years),and native Tibetans at high-altitude (NTH).Color duplex Doppler sonography (CDDS) was used to measure bilateral vertebral and internal carotid arterial diameters,mean flow velocities.The heart rate,arterial blood pressure,and arterial oxygen saturation were also recorded simultaneously,and in combination,hemoglobin was measured to assess total cerebral blood flow (TCBF),total cerebrovascular resistance (TCVR),and total cerebral oxygen supply (TCOS).Results After migration to high-altitude,Hans' TCVR and TCBF maintained the level of NHS after transient changes during early stage (P<0.05),and the TCBF was markedly higher than that of NTH (P<0.05);while the blood pressure and TCOS increased abruptly (P<0.05) at the beginning and kept for a relatively long time at a constant level which were higher than those of NTH all the time (P<0.05).Conclusions Han migrants can acclimate to high-altitude by adaptive change of cerebral blood flow over a short time and maintain a constant adaptability which is always weaker than that of native Tibetans.CDDS can be used for non-invasive measurement of actual cerebral blood flow,and is of good value in the study on high-altitude-related cerebral hemodynamics.

Objective To explore the preparation of specific immune RMA(iRNA) on anti-rabies and further study immunotherapy of rabies virus exposure. Methods Horses were immunized with the rabi-es virus and their livers were isolated from the horse of antiserum, from which total RNA was extracted and purified by sodium lauryisulfonate, phenol, chloroform, ethyiene glycol monomethyl ether, cetyltrimethyam-moniumbromide and alcohol. Results Pure preparation physico-chemical characterization was analyzed, and it's weight was 0.15% of weight of liver. The RNA contained 2.86% DNA and 1.16% protein. The iRNA with a maximum UV absorbance at 258 nm and A_(258/280) about 2.0. The test of RNA was positive, which had a relative molecular mas of 13.7×10~3 by high performance liquid chromatography(HPLC), and its hy-perchromic effect was 50.67%. The vesults of biological activity was showed that the rate of leucocyte adher-ence inhibition(LAI) was 41.73%, The protective rate was 50% and prolonging the life was 31.62%. Conclusion The results obtained with the practical value were identical and provide a basis on medicines of anti-rabies.

OBJECTIVE To investigate the storage time and the origin of bacteria for disinfection package for combat readiness under natural environment in inland and plateau situation.METHODS We prepared double-cotton operation dressing packet,apparatus package,as well as dressing and apparatus mixed packet each with 72 pieces,respectively.Packages were deposited within closed and opened storage boxes under natural environment in depository for combat readiness,respectively after vacuum steam sterilization.Three different kinds of packages each with 3 items were put inside each box.After sterilization,total of 9 items with each 3 from one type of package were taken randomly from each group every time for bacterial culture by different time.At the same time,samples of the air and depot boxes in warehouse for combat readiness were collected and cultured as well as analyzed for bacterial homology.RESULTS In Chongqing,all packages were negative for bacteria on the 40th day after sterilization,while 2 packages were positive for bacteria on the 49th day.In Lhasa,4 packages were positive in opened group on the 106th day after sterilization.On the 122nd day,6 packages were positive in opened group and 1 item was positive in closed group.The dominant bacteria are bacilli and staphylococci both in the air and depot boxes of the warehouse for combat readiness.CONCLUSIONS The storage time for disinfection package under natural environment in different areas correlates closely with the local environmental and climatic situations.The bacteria of the package were confirmed to be from the air.The effective storage time for disinfection package would be prolonged by standardization of the disinfection procedure,and control multiple environmental factors affecting microorganisms.